GMC

Following the success of our conference back in April this year, we are pleased to announce we will be running another similar event in November.

We want to get as many people as possible involved in medical education by showcasing the superb work done in the Trust. We also want to offer high quality, local, approved training to clinical and educational supervisors who do so much to support undergraduate and postgraduate education in the trust.

The Trust’s second Medical Educators’ Conference will be held on Friday 7th November 2014 . This event is for clinical and educational supervisors of postgraduate and undergraduate medical trainees.

The conference is designed to support educators’ continuing professional development, keep educators abreast of changes in medical education and facilitate peer support and networking amongst educators and the Postgraduate Medical Education Team. The event will allow educators to fulfill appraisal requirements and meet the GMC standard for approved trainer status. For existing supervisors, this will count as sufficient activity to keep their GMC approved trainer status in the current year.
There will be speakers from the Postgraduate Medical Education Team, as well the North Western Deanery and the Manchester Medical School amongst others. Interactive workshops will include topics such as managing doctors in difficulty, giving effective feedback and undergraduate tutor training.
Click the Medical Educators’ Conference Flyer here for more information:

Last year we had the pleasure of meeting the GMC when they visited the NW region. Our visit was part of a wider process looking at medical education across the North West and at all stages from undergraduate through to postgraduate training.

Although the visits took place last year it is only now that the full reports have been released online and they are freely available to everyone. The GMC have a policy of disclosure so trainees, trainers, the public and press get to see what was written about us and about the quality of training across the NW in general.

Worried?

Well, we can all do better as they say, but in all honesty the region and the trust gets a good report. We had one area of good practice highlighted (skills teaching for undergraduates) and five requirements relating to induction, workload for CMT trainees, the organisation of year 4, the use of the SHO nomenclature and time in job plans for trainers.

On the same site you will find the reports for Manchester medical school and the wider NW deanery. Again, for those with an interest in the organisation and delivery of training these are useful reading to see what’s going on across the region.

It’s always interesting to read what the regulator thinks about training. They obviously have a huge influence on current and future training patterns and as those of you at the recent educators conference know, change is inevitable and may be quite radical.

My only concern with the report is that the GMC only looked at a few small elements of postgraduate training here at CMFT and that’s a shame as we did not get that much of an opportunity to showcase what we do well. I think this is a consequence of the GMC’s policy of targeting visits to areas where they believe there may be concerns, but it is a bit of a shame. We all like our report cards to have lots of positives as well as areas of improvement.

There’s quite a bit of guidance out there already, including the latest release of trust guidelines on the use of social media by staff. If you’re into this sort of thing give it a quick read. There’s little controversial in there and it’s all basically sensible stuff.

In summary the rules for social media are pretty much the same rules as in all other forms of communication. Be sensible, be wise and don’t say anything online that you would not be prepared to be overheard whilst talking at a bus stop.

Social media does not make clinicians make errors, it’s just that when they do make mistakes it has the potential to be done in front of a much wider audience. As a colleague once put it…

‘social media does not make someone an idiot, it just helps them announce it to many more people’

My only concern is that we do not get carried away with the potential dangers of social media without also embracing the incredible potential for education and development. Learning through social media is already commonplace in many professions and within some medical specialities, it is inevitable that we will see a growth in clinician involvement and participation over the next few years.

I’ve recently been forced to consider the longevity of the SHO grade. This is not an idle pursuit but a requirement as over the last few years there have been a number of patient safety reports highlighting the difficulties in the use of the term SHO, or ‘senior house officer’. The title has not existed as a training grade for many years (2005?? if I remember rightly), but the term remains in common parlance.

Is this a problem?

Well, if usage is anything to go by, then to some it isn’t. It appears to be widely used by a variety of different staff perhaps having become one of those terms that is difficult to define, but seemingly everyone knows what it means….

Or do they?

We have pretty much disbanded the term house-officer in favour of foundation doctor (although some die-hards do remain), but SHO seems more sticky. It is an all encompassing term that links years 1-3 core/specialist training posts. FY2 docs, clinical fellows, trust fellows and a bunch of other trainees into one amorphous mass which belies the variability in experience and skill within. There is clearly a significant difference in experience (and ability) between an FY2 and an ST3 so it is disingenuous and potentially dangerous to consider them to be all the same….., a nurse (for example) requesting an ‘SHO’ to see a patient may get a doctor with wildly different levels of experience and that can’t be good. So why does the term continue? I think it is a mixture of convenience and history. SHO rolls off the tongue in a way that ‘core trainee, year 1, Acute Common Care Stem (Emergency Medicine)’ does not. It just does. and there is little we can do about this, but that does not mean that it is unimportant. The question has been raised as a patient safety concern by the deanery and by national bodies for good reason, so we must do what we can to change the current custom and practice. Here at CMFT we are going to try the following.

Stop the issue of ID cards with ‘SHO’ on them.

Stop doctors from trying to choose their own titles for ID cards.

Don’t advertise any job as an SHO post.

Change rotas to reflect true grade and not ‘HO’ or ‘SHO’

Use alternative grading systems. For example In the ED and medicine we use different coloured lanyards to designate roles and responsibilities (so the whole team can see who is operating at whichever level in the clinical setting).

Will this work? We hope so as we’d like to think that the term ‘SHO’ is dead….., my concern is that it might only be resting unless we take steps to make sure that he not just (as Monty Python might say) pining for the Fjords……

Having been through revalidation this year I can instantly sympathise with any colleague who may be putting together the evidence to ensure that we can keep working. For the vast majority of consultants the process should be fairly straightforward as it is largely based on the annual appraisal process which is well embedded in the trust. This process should cover all aspects of practice and for clinical and educational supervisors this means that appraisal (and thus revalidation) should address how you perform as a supervisor.

So what does this mean in practice?

Essentially, it means that consultants who are working as clinical and educational supervisors will need to demonstrate that they are up to speed and developing in this area of their practice. In the web based system (currently Equiniti as used by many trusts including CMFT), there is a specific section that collates and maps evidence around educational activities and the expectation is that if you are working as a CS/ES then you will be able to show continuing professional development in this area.

So who decides on what constitutes evidence?

A good question as there are a whole range of activities that colleagues undertake to ensure that they become better supervisors over time. The current recommendation from the deanery (who monitor and approve the trust in this area) is that a CS/ES will show evidence of CPD in one of the 7 domains as defined by the Academy of Medical Educators.

We would also like to encourage as many consultants as possible to join the Academy and this would be a strong evidence of your development as an educator. Remember that you get a discount on membership and fellowship if you work for the trust.

OK, but how do I know if the level of training is ‘enough’? What about quality?

We have taken a pragmatic approach to this as we want to encompass a range of skills/courses/activities that embrace the diversity of specialities that we have at CMFT. Some activities will be generic (e.g. completing a Postgraduate Certificate in Education), whereas others may be speciality specific (e.g Ophthalmology college trainers day). Most will be self evident, but advice should be sought from divisional leads if an appraiser or appraisee is in doubt.

Hmm, I teach undergraduates and postgraduates – do I have to do this twice?

Nope. Again, we know that our education team is busy and duplication upsets everyone. We have come to an agreement with the undergraduate team that generic teaching skills are exactly that – generic! So, if you completed a course on examining in undergraduate medicine that would be great evidence for development in ‘assessment’ for both your undergraduate and postgraduate roles.

So how will you know if this is working?

We are required to keep a log of who is and who is not accredited and that information will come through the appraisal system. We will sample the quality of evidence on an annual basis to ensure that clinicians are only accredited when it is valid to do so.

So in summary we are working to make the process of accreditation as easy, reliable and as valid as we can. If you have any questions or concerns then please get in touch with the team in postgrad or undergrad.

We have some great news for anyone who has completed a Generic Instructors Course (GIC) for the Advanced Life Support Group. The Academy of Medical Educators (AOME) has approved the course as an equivalence route for membership of the academy. In the past membership was obtained by completing an application form involving a fair bit of reflective writing and evidence. It was good, but it did take a bit of work and I think it put a lot of people off applying. The new automatic approval process means that if you have passed the GIC you will be automatically accepted as a member of the Academy.

Is it worth it you may ask? Well there is a fee (which is not inconsiderable) but this needs to be balanced against the benefit of external validation of your educational abilities (which is increasingly useful for revalidation & appraisal). The Academy is also doing a lot of work to recognise education as an integral part of being a clinician and will keep you up to date with local and national opportunities for educator development. We are proud to say that CMFT is a corporate partner of the academy so if you are an employee here you are eligible for the reduced rate in brackets below (and it’s tax deductable of course).

Salary above £60k

Salary below £60k

Retired

F/T Student

Fellowship

£275 (£183)

£135 (£90)

£75

n/a

Membership

£225 (£150)

£110 (£73)

£60

n/a

Associate Membership

£90 (£60)

£70 (£46)

£30

£10

Foundation Member*

£175 (£116)

£95 (£62)

£50

£30

If you want to know more about the benefits of joining the academy then please do get in touch with postgrad and/or have a look at the following document from the academy itself.

If you are not a GIC certified instructor then don’t worry you may well still be eligible for membership or fellowship of the academy. A number of workshops on applications are planned by the academy around the country and you can attend one of those, or contact postgrad and we will put you in touch with one of the many fellows who already work in the trust.